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What is dysphagia?

Dysphagia refers to any disorder in the swallowing process that does not allow food or fluid to pass safely from the mouth to the stomach[1]. It is a common condition in many patient types and has various causes related to physical or mental disorders.

How does it happen?

The mouth and tongue play a vital role in the swallowing process. If the muscles in the mouth or tongue become weaker or uncoordinated, there is a risk that food or drink that is swallowed may end up in the lungs rather than the stomach. This can have serious health consequences.

Different categories

Dysphagia can be classified into 4 categories, listed from most to least common [1]:

  • Oropharyngeal : patients having difficulties with the passage of food bolus from oral cavity to cervical oesophagus
  • Oesophageal : impairment in the passage of solid/liquid food through the oesophagus
  • Oesophagogastric : impairment in the passage of food  from the oesophagus to the stomach due to motor or physical obstruction.
  • Paraoesophageal: physical impingement on, or infiltration of the oesophageal wall leading to obstruction

Worldwide prevalence

Dysphagia is generally a sign of underlying diseases that can be associated with varied diagnoses[2]. Neurological disorders, cancer and age-related physiologic changes are the major primary diagnosis associated with swallowing difficulties[3].


Dysphagia prevalence 
Figure : Worldwide dysphagia prevalence [4,5,6,7,8]

References

  1. Wolf DC. Clinical Methods: The History, Physical, and Laboratory Examinations; Chapter 82 Dysphagia Stoneham (MA): Butterworth Publishers ; c1990.
  2. Groher ME, Bukatman R. The prevalence of swallowing disorders in two teaching hospitals. Dysphagia 1986 1. 3-6.
  3. Schumacher S.,  Müller M. Schweiz Med Forum 2007;7:130-134
  4. Lieberman AN, Horowitz L, Redmond P, Pachter L, Lieberman I, Leibowitz M. Dysphagia in Parkinson's disease. Am J Gastroenterol. 1980 Aug;74(2):157-60.
  5. Perry L, Love CP. Screening for dysphagia and aspiration in acute stroke: a systematic review. Dysphagia. 2001 Winter;16(1):7-18.
  6. Easterling, C and Robbins, E. Dementia and dysphagia. Geriatr Nurs. 2008;29(4):275-285.
  7. Kalia M. Dysphagia and aspiration pneumonia in patients with Alzheimer's disease. Metabolism. 2003 Oct;52(10 Suppl 2):36-8.
  8. García-Peris P, Parón L, Velasco C, de la Cuerda C, Camblor M, Bretón I, Herencia H, Verdaguer J, Navarro C, Clave P. Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: Impact on quality of life. Clin Nutr. 2007 Dec;26(6):710-7.